TLC Michigan, LLC

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

Legal business name

TLC MICHIGAN, LLC

Practice address

34405 W 12 Mile Rd
Suite 154
Farmington Hills, MI 48331-3391

Phone

(248) 489-0400

NPI assigned

May 9, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Greg Antilla

Title

VP of Finance

Phone

(734) 761-2235

Specialties & licenses 1

Addresses

Tax ID family

TLC Michigan LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• TLC Michigan, LLC

  • Clinic/Center
  • Chesterfield, MO
  • NPI 1437362563
  NPD tax ID

Locations

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• TLC Laser Center of Detroit, LLC

  • Clinic/Center
  • Farmington Hills, MI
  • NPI 1013120641
  NPPES parent name

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1178668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1407060874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2723 S STATE ST",
            "address_2": "SUITE 220",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481046188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34405 W 12 MILE RD",
            "address_2": "SUITE 154",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483313391",
            "telephone_number": "248-489-0400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TLC MICHIGAN, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ANTILLA",
        "authorized_official_first_name": "GREG",
        "authorized_official_title_or_position": "VP OF FINANCE",
        "authorized_official_telephone_number": "734-761-2235"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexandria Tiznado
• Karyna Tkachenko
• Victoria Tkaczyk
• TLC Home Aide Corp.
• TLC Laser Center of Detroit, LLC
• Ngun Tlumang
• TMG Dental Health Foundation, Inc.
• TMG Dental Health Services
• Victoria Tobey
• Colleen Tobin

• Ophthalmology Physician in Farmington Hills, MI
• Providers in Farmington Hills, MI by specialty
• Ophthalmology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.